Health in the Americas: Potentially avoidable premature mortality
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Health in the Americas: Potentially avoidable premature mortality. (2024). [Publications]. PAHO. https://iris.paho.org/handle/10665.2/58106
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English; 172 pages
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2024
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ISBN: 978-92-75-12793-3 (PDF)
ISBN: 978-92-75-12794-0 (Print version)
ISBN: 978-92-75-12794-0 (Print version)
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In recent decades, a significant improvement in people’s general health conditions has occurred, leading to an increase in life expectancy at birth in most countries in the Region of the Americas. This progress has been the result of both health technology advances – antibiotics, vaccines, and other treatments – and improvements in the conditions in which people live, including increased access to improved drinking water and sanitation, and health services. Nevertheless, progress has slowed in recent years, and achievements have varied among countries and territories, as well as within them. In the journey toward universal health, it is essential to have the ability to monitor and assess progress in terms of the ultimate goal of health systems: improving the health and well-being of populations. To this end, this edition of Health in the Americas analyzes the standardized rate of potentially avoidable premature mortality as an indicator of health system performance, considering both its preventable component through public and intersectoral health interventions, as well as the treatable component, related to the effectiveness of health services, that is, the quality of health care. The analysis of potentially avoidable premature mortality provides a metric for comparing and tracking performance over time. This analytical tool plays a crucial role in holding health systems accountable in the Region of the Americas. Furthermore, the analysis of potentially avoidable premature mortality highlights the importance of investing not only in healthcare services but also in addressing the broader social and environmental determinants of health. This approach is fundamental to ensuring equity in health outcomes across countries. By recognizing the significance of these determinants, countries can develop comprehensive strategies that encompass not only health care but also social policies aimed at reducing inequalities and improving overall population health.
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CVD-DM mortality rates ranged from 10.7 – 247.1 per 100 000, with a mean of 92.3 and standard deviation of 47.6. Of the 17 countries, 12 showed a reduction in premature CVD-DM mortality in both men and women, with others either showing no improvement or increases. Mortality rates for men were 1.46 times higher than for women. On average, there was a 68% increase in health care expenditure, with a 15.4% fall in CVD-DM mortality in women and 4.9% in men. Mixed effects modelling demonstrated a weak association between health care expenditure and declining CVD-DM mortality for both women -0.006 (95%CI = -0.014 – 0.001) and men -0.008 (95%CI = -0.017 – 0.001). Conclusions. Findings suggest that progress has been made to reduce premature CVD-DM related mortality in a number of Caribbean countries. 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Because countries worldwide vary widely in the capacity of their digital health infrastructure and their development stages, there lies a unique opportunity to foster international collaboration, share knowledge and drive global standards that support the widespread adoption of telehealth solutions for leaving no one behind. This strategic focus is predicated on the understand- ing that telehealth serves as both a catalyst for health equity and a critical tool for reinforcing health systems grounded in primary health care (PHC). The scientific rationale behind this concerted effort is clear: by enhancing digital infrastructure and fostering the adoption of telehealth solutions, there is potential to bridge the global digital divide and democratize access to health services. 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The current emphasis is on the primary and preventive care focusing on the prevalence of lifestyle and behavior related conditions as indicated by the country’s epidemiological profile. MoH implemented the Health Sector Reform project consisting of three major components, namely, sector restructuring, services rationalization and improvement, and financing strategy...
